Development of Recommendations for Speech-Language Pathologists in Paediatric Palliative Care Teams (ReSP3CT)

This three-phase modified Delphi study is comprised of a survey, interview and Delphi panel phase. Initially, preliminary data needed for the creation of statements for consensus will be collected from clinicians currently working in the field by the lead investigators. This will be completed via distribution of cross-sectional online surveys to identify ‘specialists’, followed by an in-depth interview protocol to identify common themes to synthesise preliminary recommendations/statements for consensus within the final Delphi study phase. The ReSP3CT study will take place in various clinical and non-clinical settings within synchronous (real-time) and asynchronous environments; utilising email communication, online surveys and interviews via video-conferencing. It is anticipated that the total time required for data collection will be 12-18 months. For this study, participants be speech-language pathologists who have worked for a minimum of two years with a paediatric palliative caseload. Participants will be included in this study if they have native-level proficiency of English and are eligible for membership in their respective professional SLP associations. Survey: A cross-sectional survey will be distributed online following recruitment, to document characteristics in this sample of clinicians working with this population. Open and closed ended questions will be used in the online survey design and will be grouped thematically for ease of coding. Closed ended questions will be used to obtain participant characteristics such as sex, qualification level, years of practice as an SLP and years worked in a palliative context. Open ended questions will be used in the survey to obtain broader information about their perceptions of the SLP role within paediatric palliative care, each scope of practice area, and if relevant, palliative care teams. Interview: Following the cross-sectional survey, participants will be asked to participate in a 60-90 minute in-depth interview (one-on-one) in order to gather their opinions, experiences and concerns of working in paediatric palliative care settings and/or treating children who are being managed palliatively. Conducted by a university academic from La Trobe University, this phase will involve further exploration of any common or unique themes that emerged within the online survey. These interviews will be video/audio recorded to ensure accurate transcription of data to allow for analysis/coding of themes. Delphi panel: An online questionnaire will be disseminated to participants comprising of statements based on the themes/codes that arise from data gathered from the literature review and the first and second points of participant contact (survey and interview). To minimise researcher bias, the synthesis and iterations of each statement will be reviewed by co-investigators before sending these to participants. Statements will be presented to participants using a five-point Likert scale (responses include: strongly disagree – disagree - …etc.). Participants will have the opportunity to provide a comment on each item to qualify their response to assist with shaping/rephrasing the statement for future iterations to aid in reaching agreement – responses will be analysed using Colaizzi's seven-stage thematic analysis as described by Holloway and Galvin. This form of thematic analysis will be used to duplicate the data analysis protocol previously used for measurement of consensus and stability in Delphi studies. At the end of each questionnaire, participants will have the opportunity to rank the statements from ‘most’ to ‘least’ important in for SLPs working in PPC. The Delphi process for each statement will stop if a statement yields greater than or equal to 70% agreement among participants on a five-point Likert scale in the top two measures and an interquartile range (IQR) of less than or equal to 1, or, a ceiling of five rounds is reached.